Exposure assessment of particulates, carbon monoxide, volatile organic compounds and formaldehyde in surgical smoke

Background and Objectives: Electro-cautery is vital to coagulate blood vessels in order to reduce blood loss and operation time. Health hazards of surgical smoke are well documented in academic literature. The exact risk from surgical smoke to surgeons and other members in surgical staff in the operation room is still not clear. This study assesses the health effects in surgeons from exposure to particulates, carbon monoxide, volatile organic compounds (VOCs) and formaldehyde found in surgical smoke. Additionally, this study quantifies the exposure of surgical staff to these chemicals in surgical smoke during open and laparoscopic procedures. Finally, this study evaluates the efficiency of surgical smoke evacuation systems to restore a smoke-free environment. Method: A health symptoms questionnaire was sent to approximately 200 surgeons in a medical center. We measured particulates and carbon monoxide using direct reading instruments and VOCs and formaldehyde using passive badges. Area monitoring was conducted in the presence and the absence of surgical smoke evacuation systems and continued one hour after surgery. Results: Some surgeons will report adverse health effects associated with exposure to surgical smoke. Though the levels of particulates, carbon monoxide, VOCs and formaldehyde will gradually decrease after surgery during area monitoring, we expect the persistence of these chemicals even after surgery and in the presence of surgical smoke evacuation systems. Conclusion: This study will help to determine the persistence of chemicals in surgical smoke in the presence of engineering controls and its effect on surgeons' health.